Nuclear magnetic resonance (NMR) has long been used in the fields of clinical and academic research. It also has a lengthy history in diagnostics, perhaps most notably for its role in magnetic resonance imaging (MRI). In recent years, the application of NMR in diagnostics is broadening in scope, such that it may be used in other areas in the frontline health care industry.
The benefits afforded by advancing NMR techniques include robust, reproducible results that can provide rapid and accurate information about a variety of diseases. New technologies allow for quick, straightforward, and cost-effective screening for a range of disease markers. Some of the fields in which NMR may be useful include diagnosis of liver disease, kidney disease, neurological disorders, cardiovascular disease, and cancer. In particular, NMR is being more broadly used in metabolomics whereby metabolites are analyzed to more effectively diagnose and treat disease.
Here, we explore the history of NMR in diagnostics and the progress that is being made in the field.
Traditional use of NMR in diagnostics
In NMR spectroscopy, atoms in a constant magnetic field are subjected to radio frequency radiation that forms a second oscillating magnetic field. Upon absorption of radio frequency energy, the phenomenon of NMR causes the nuclei of atoms to resonate. The frequency of this resonance and the resulting electromagnetic signal is characteristic of the magnetic field at the nuclei of atoms.
When detected using an NMR spectrometer, this resonance can help determine the chemical, physical, and biological properties of substances of interest. NMR was first used to assign previously unknown molecular structures in 1955, and is still widely used to determine the structure and identity of molecules. NMR spectroscopy is a hugely useful analytical tool that’s utilized in many laboratories across a range of disciplines. Some key uses include investigating the structure of organic molecules and studying molecular physics.
NMR is broadly used in the medical field, and perhaps the most well-known application of NMR is MRI. MRI is a multidimensional imaging technique that uses the NMR phenomenon to create images of parts and processes of the body in medical diagnostic applications.
This method is popular for multiple reasons—key advantages being that it is non-invasive and non-destructive. It is highly useful for diagnostic imaging of soft tissues, including the heart, brain, and muscles, and can often be used to discover tumors in various parts of the body. The technique was first developed in the 1970s, with MRI machines becoming commercially available in the 1980s. Now, millions of MRI scans are conducted in the US each year.
NMR is currently advancing the field of diagnostics
While MRI is now a staple in today’s world of diagnostics, the research and innovation around NMR techniques doesn’t stop there. For example, NMR is very useful in areas of biomedical research such as the study of protein and peptides, as well as individual amino acids and nucleic acids. It can be used to analyze structure, dynamics, and interactions.
In recent years, NMR has been featured heavily in the area of metabolomics. This rapidly growing field involves the study of metabolites to discover information about diseases. The use of metabolomics has traditionally weighed toward research applications, but there is increasing potential for it to be extremely helpful in laboratory diagnostics. Metabolomics can provide valuable information about downstream products of metabolic and cellular processes, offering insight into the status of certain tissues and organs. NMR spectroscopy is being used successfully to quantify metabolite concentrations in various fluids, including urine, plasma, and serum.
One organization leading the way in this field is numares. This company focuses on metabolomics-based diagnostics used to interpret biomarkers. Together with Bruker, numares is working to deliver NMR-based diagnostics tests to the laboratory market.
The numares platform, branded AXINON®, can provide rapid access to accurate and personalized data pertaining to the progress and severity of the disease being studied. The tests use a high-strength magnetic field in combination with artificial intelligence technology to automate the measurements of metabolites. They analyze clusters of risk factors (referred to as “constellations”) as opposed to individual biomarkers. The process is non-invasive and may be used in the treatment and prevention of a range of diseases.
The collaboration between Bruker and numares aims to take the AXINON® platform to the next level. While it was previously confined to research use, the goal is to make it available as a routine, affordable clinical tool available to all patients. One project involves the launch of a novel blood test that allows for the identification and quantification of impaired kidney function. Another test already available determines lipoprotein subclasses in serum.
This collaboration follows other fruitful partnerships that numares has formed. In 2017, the company collaborated with Oxford University in the development of diagnostic tests for multiple sclerosis. And in 2019, a collaboration with Mayo Clinic Laboratories led to the development of clinical diagnostic tests that utilized NMR technology. These tests analyzed metabolite constellations and focused on several types of disease, including kidney disease, liver cancer, and cardiovascular disease.
Ultimately, there is hope that bringing advanced NMR diagnostic techniques to the frontline health care industry will allow for the swift, cost-efficient diagnosis of a broad spectrum of diseases.